Atherosclerosis and Lipoproteins |
From the Department of Epidemiology & Biostatistics (A.E.H., H.A.P.P., A.H., J.C.M.W.) and the Department of Internal Medicine (A.E.H., H.A.P.P.), Erasmus University Medical School, Rotterdam, the Netherlands, and the Department of Clinical Epidemiology (A.M.v.H.), Leiden University Medical Centre, Leiden, the Netherlands.
Correspondence to Dr J.C.M. Witteman, Department of Epidemiology & Biostatistics, Erasmus University Medical School, PO Box 1738, 3000 DR Rotterdam, The Netherlands. E-mail witteman{at}epib.fgg.eur.nl
AbstractAtherosclerosis and osteoporosis are major causes of morbidity and mortality in postmenopausal women and have been suggested to be associated. No study has examined whether progression of atherosclerotic calcification is associated with bone loss. In the present study, we examined progression of aortic calcification, diagnosed by radiographic detection of calcified deposits in the abdominal aorta, in relation to metacarpal bone loss, as assessed by metacarpal radiogrammetry, during menopause. Initially premenopausal women (n=236), aged 45 to 57 years at baseline, were followed for 9 years. We additionally assessed the cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density in 720 postmenopausal women. Twenty-five percent of women going through menopause showed progression of aortic calcification. The average loss of metacarpal bone mass among women with progression of aortic calcification was 3.2 mm2, and their loss of metacarpal bone density was 7.2 mm2 %, whereas in women without progression of aortic calcification, these losses were 2.0 mm2 and 5.6 mm2 %, respectively, adjusted for age and years of follow-up (P<0.05). Additional adjustment for age at menopause, body mass index, blood pressure, smoking, diabetes mellitus, and use of hormone replacement therapy, thiazide, and loop diuretics did not influence these results. In postmenopausal women, a graded inverse cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density was found. In conclusion, our results indicate that progression of atherosclerotic calcification is associated with increased bone loss in women during menopause.
Key Words: atherosclerosis vascular calcification osteoporosis menopause
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